A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling?
Thiamine deficiency (TD) in non-alcoholic hospitalized patients causes a variety of non-specific symptoms. Studies suggest it is not rare in acutely and chronically ill individuals in high income countries and is underdiagnosed. Our aim is to demonstrate data which help define the risk factors and c...
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doaj-b1450168d14f436cb4909971b22382142021-04-01T23:11:01ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01101449144910.3390/jcm10071449A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling?Elisabeth Mates0Deepti Alluri1Tailer Artis2Mark S. Riddle3Medicine Department, Veterans Affairs Sierra Nevada Healthcare System, Reno, NV 89502, USASound Physicians, Lutheran Hospital, Fort Wayne, IN 46804, USASchool of Medicine, University of Nevada, Reno, NV 89502, USAMedicine Department, Veterans Affairs Sierra Nevada Healthcare System, Reno, NV 89502, USAThiamine deficiency (TD) in non-alcoholic hospitalized patients causes a variety of non-specific symptoms. Studies suggest it is not rare in acutely and chronically ill individuals in high income countries and is underdiagnosed. Our aim is to demonstrate data which help define the risk factors and constellation of symptoms of TD in this population. We describe 36 cases of TD in hospitalized non-alcoholic veterans over 5 years. Clinical and laboratory data were extracted by chart review +/− 4 weeks of plasma thiamine level 7 nmol/L or less. Ninety-seven percent had two or more chronic inflammatory conditions (CICs) and 83% had one or more acute inflammatory conditions (AICs). Of possible etiologies of TD 97% had two or more of: insufficient intake, inflammatory stress, or increased losses. Seventy-five percent experienced 5% or more weight loss. Ninety-two percent had symptoms with the most common being weakness or falling (75%) followed by neuropsychiatric manifestations (72%), gastrointestinal dysfunction (53%), and ataxia (42%). We conclude that TD is underdiagnosed in this population with consequent morbidity and mortality. TD likely develops because of inflammatory stress from CIC’s compounded by AIC’s combined with decreased energy intake or increased nutrient losses.https://www.mdpi.com/2077-0383/10/7/1449thiamine deficiencydeliriumfallsthiamine deficiency symptomsencephalopathyinpatient |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elisabeth Mates Deepti Alluri Tailer Artis Mark S. Riddle |
spellingShingle |
Elisabeth Mates Deepti Alluri Tailer Artis Mark S. Riddle A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling? Journal of Clinical Medicine thiamine deficiency delirium falls thiamine deficiency symptoms encephalopathy inpatient |
author_facet |
Elisabeth Mates Deepti Alluri Tailer Artis Mark S. Riddle |
author_sort |
Elisabeth Mates |
title |
A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling? |
title_short |
A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling? |
title_full |
A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling? |
title_fullStr |
A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling? |
title_full_unstemmed |
A Retrospective Case Series of Thiamine Deficiency in Non-Alcoholic Hospitalized Veterans: An Important Cause of Delirium and Falling? |
title_sort |
retrospective case series of thiamine deficiency in non-alcoholic hospitalized veterans: an important cause of delirium and falling? |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-04-01 |
description |
Thiamine deficiency (TD) in non-alcoholic hospitalized patients causes a variety of non-specific symptoms. Studies suggest it is not rare in acutely and chronically ill individuals in high income countries and is underdiagnosed. Our aim is to demonstrate data which help define the risk factors and constellation of symptoms of TD in this population. We describe 36 cases of TD in hospitalized non-alcoholic veterans over 5 years. Clinical and laboratory data were extracted by chart review +/− 4 weeks of plasma thiamine level 7 nmol/L or less. Ninety-seven percent had two or more chronic inflammatory conditions (CICs) and 83% had one or more acute inflammatory conditions (AICs). Of possible etiologies of TD 97% had two or more of: insufficient intake, inflammatory stress, or increased losses. Seventy-five percent experienced 5% or more weight loss. Ninety-two percent had symptoms with the most common being weakness or falling (75%) followed by neuropsychiatric manifestations (72%), gastrointestinal dysfunction (53%), and ataxia (42%). We conclude that TD is underdiagnosed in this population with consequent morbidity and mortality. TD likely develops because of inflammatory stress from CIC’s compounded by AIC’s combined with decreased energy intake or increased nutrient losses. |
topic |
thiamine deficiency delirium falls thiamine deficiency symptoms encephalopathy inpatient |
url |
https://www.mdpi.com/2077-0383/10/7/1449 |
work_keys_str_mv |
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